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Warfarin does not need to be stopped before primary care dental surgical procedures

Warfarin does not need to be stopped before primary care dental surgical procedures - That is the conclusion of a review from an evidence-based website in Great Britain (see: http://www.dundee.ac.uk/tuith/Static/info/warfarin.pdf). This is an excellent review and discussion, but it should be noted, however, that their review does not endorse the use of tranexamic acid mouth wash mainly because it is not readily available in the United Kingdom and it is rather expensive. Both tranexamic acid and aminocaproic acid are fibrinolytic inhibitors so that the use of these agents serve to counteract bleeding risk. In the U.S., aminocaproic acid (Amicar) is readily available as a 5 Gm vial for injection and it is relatively inexpensive. In our own clinic, we routinely use Amicar as a mouth wash to reduce bleeding risk of dental procedures. A discussion of the use of Amicar for this purpose is available at http://www.clotcare.com/clotcare/faq_amicarsolution.aspx.